Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 125057887 | IL |
NPI | 1235443474 |
---|---|
Provider Name | Dr. Damien P Kenny |
First Address | Chicago, IL 60612-3800 |
Second Address | Chicago, IL 60612-3800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2010 |
Last Update Date | 31/03/2014 |